Suprasacral Parallel Shift - Ultrasound/MR Image Fusion Guided Lumbosacral Plexus Block

Thomas F. Bendtsen

Status and phase: Completed; Phase 1

Conditions: Hip Fractures; Pain, Perioperative; Anesthesia Local

Treatments: Drug: Lidocaine-epinephrine added gadoterate meglumine

Study type: Interventional

Funder types: Other

Identifiers

NCT02593370

AUH-TFB-SSPS

Details and patient eligibility

About

The main objective of the trial is to complete a double-blinded randomized controlled trial with crossover design of a lumbosacral plexus block with the Suprasacral Parallel Shift technique guided by ultrasound/magnetic resonance (MR) image fusion vs. Suprasacral Parallel Shift guided by ultrasound by estimating sensory block of the femoral nerve, the obturator nerve, the lumbosacral trunk, and spinal nerve L1 in healthy volunteers.

Full description

The main objective of the trial is to complete a double-blinded randomized controlled trial with crossover design of a one-injection nerve block of the lower part of the lumbar plexus and the upper part of the sacral plexus (Suprasacral Parallel Shift, SSPS) to achieve analgesia of the femoral nerve, the obturator nerve, the lumbosacral trunk, and spinal nerve L1 with SSPS guided by ultrasound/MR image fusion vs. SSPS guided by ultrasound by estimating sensory block of in healthy volunteers by estimating the sensory block of dermatomes of the terminal nerves in healthy volunteers.

The secondary objective is to estimate a) preparation and b) procedure time, c) injection site and d) depth, e) discomfort, f) change in MAP, g) plasma lidocaine pharmacokinetics, h) motor and i) sensory block, j) perineural and k) epidural spread of lidocaine-epinephrine added gadotorate meglumine on MRI, and l) cost-effectiveness of SSPS guided by ultrasound/MR image fusion vs. SSPS guided by ultrasound.

The investigators hypothesize that block success is higher for SSPS guided by ultrasound/MR image fusion than for SSPS guided by ultrasound.

Enrollment: 26 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Age ≥ 18 years
• Volunteers who has given their written and oral informed consent to participate in the study after having fully understood the content and the limitations of the protocol.
• Normal healthy person (American Society of Anesthesiology [ASA] Classification I)

Exclusion criteria

• Volunteers not able to cooperate in the study
• Volunteers not able to understand or speak Danish
• Daily use of analgesics
• Allergy against the medicines used in the study
• Drug abuse (according to the investigator's judgement)
• Alcohol consumption greater than the recommendations of the Danish National Board of Health
• Contraindication for MRI including pregnancy
• Volunteer in whom nerve blocks are not possible due to technical reasons
• Volunteer who are incompetent (ie. surrogate consent is not accepted)

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: Double Blind

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26 participants in 2 patient groups

Suprasacral Parallel Shift guided by US/MR image fusion

Experimental group

Description:

Use of ultrasound/MR image fusion guided Suprasacral Parallel Shift technique to place a lumbar plexus block (20 mL 2% lidocaine with epinephrine added gadoterate meglumine).

Treatment:

Drug: Lidocaine-epinephrine added gadoterate meglumine

Suprasacral Parallel Shift guided by US

Active Comparator group

Description:

Use of ultrasound guided Suprasacral Parallel Shift technique to place a lumbar plexus block (20 mL 2% lidocaine with epinephrine added gadoterate meglumine).

Treatment:

Drug: Lidocaine-epinephrine added gadoterate meglumine